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Each fall, the Centers for Medicare & Medicaid Services (CMS) renews the federal guidelines that seek to protect individuals whose spouses are applying for or receiving Medicaid long-term care benefits.
These protections, known as the Spousal Impoverishment Standards, help to support the financial well-being of seniors who continue residing at home while their spouse on Medicaid lives in a long-term care facility, such as a nursing home.
Long-term care is prohibitively expensive for many, so a large share of adults aged 65 and older rely on Medicaid to help cover the costs.
To qualify for Medicaid long-term care benefits, however, one must generally have very limited resources. In most states, the asset limit is set at $2,000. (Certain assets, such as personal belongings and the applicant’s primary residence, do not count toward this limit.) The applicant’s income typically goes to the nursing home as well, with some exceptions.
So, what happens if a person who qualifies for Medicaid long-term care is married? How can their healthy spouse afford to remain on their own at home? This is where the Spousal Impoverishment guidelines help.
A spouse who continues living at home while their partner receives long-term care coverage through Medicaid can keep up to $154,140 in assets starting in 2024.
The healthy spouse, or so-called “community spouse” then has a minimum amount of assets to live on without rendering their Medicaid spouse ineligible for benefits. This special protection is known as the Community Spouse Resource Allowance (CSRA). The maximum CSRA generally rises each year; in 2023, it was $148,630.
Meanwhile, according to federal law, no state can set the minimum CSRA below $30,828 as of 2024.
In addition to CSRA, the federal government offers another level of protection for the community spouse: the Monthly Maintenance Needs Allowance (MMNA).
The MMNA ensures that the healthy spouse who continues to live in the couple’s home maintains a certain amount of monthly income while their partner receives their Medicaid long-term care coverage. (Learn more about the ins and outs of MMNA.)
In 2024, the maximum MMNA will be $3,853.50 (up from $3,715.50 in 2023). Again, this is the most in monthly income that the community spouse can keep while their spouse lives in a long-term care institution. If the healthy spouse does not make enough income to live on, this allowance comes from the income of the spouse on Medicaid.
Note that the minimum MMNA for 2024 can vary depending on your state. Alaska and Hawaii typically have slightly higher minimums. The federal government updates the minimum MMNA each July.
Certain states have in place a Medicaid income cap. If you reside in one of these income cap states, you will not qualify for Medicaid if your income equals more than $2,829 (in 2024) – unless you have a certain type of trust in place. This trust, known to many as a Miller Trust, must hold any income you receive that is above that cap.
As of 2023, the 23 income cap states were Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Louisiana, Mississippi, Nevada, New Mexico, New Jersey, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, and Wyoming.
As mentioned above, Medicaid does not consider the primary home of an applicant as a countable asset, unless the applicant’s equity interest in their home is above a certain amount.
Your home equity equals your home’s value minus the sum of any loans you owe on the home. In 2024, the home equity limit is set to $713,000. (Some states choose to raise this limit to $1,071,000.)
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A skilled nursing facility is administered b6 professionals under the direction of a physician. Many facilities also offer sub-acute, respite, rehabilitation and other short-term care. Rehabilitation services can be especially helpful for individuals who are recovering from surgery, an illness or any other life-changing event. These communities service as permanent residences for those who are too sick or frail to live at home, or as temporary facilities during a recovery period. Some residents enter a nursing care for a short-term stay after a surgery or illness, while others enter on a more permanent basis. Medicare, Medicaid, private pay insurance and personal assets are all used under various circumstances to pay for services in a skilled nursing facility. If a facility if is not certified by Medicare and Medicaid, the care will have to paid entirely with personal funds. In general, Medicare pays for skilled nursing care following a hospitalization for the same illness or condition at 100% of the cost for days 1-20. Some long-term care insurance pays for nursing care centers; insurance payments are usually a fixed amount for a specified number of qualified days. The basic daily rate is the standard charge the nursing care centers bills to all residents, which covers the fundamental services every resident receives, including rent for the room, housekeeping, meals and general nursing care. It is important to understand all the services that are not included in the basic daily rate. Below is a checklist to review options:PHYSICAL ENVIRONMENT Are public areas and resident rooms clean and comfortable?Is ample parking available for visitors? Are private rooms available? Does the community have a pet?Does the community have safety features, such as handrails and grab bars? Are the exits clearly marked?RESIDENT AND STAFF INTERACTIONHow many Registered Nurses (RNs) and Certified Nursing Assistants (CNAs) are on staff? What type of education and training do staff members have?Do all staff members undergo screenings and background checks prior to employment?How does the community handle residents who need additional care and support?Is there a care plan developed for every resident?Are care plans reviewed and updated by providers and family members?Is the interaction between residents and staff members warm and respectful?What is the staff-to-resident ratio for each level of care?Do staff members respond to residents' requests for assistance promptly?What is the staff-to-resident ratio at night and on weekends?CERTIFICATION AND LICENSUREWhat levels of care does the community offer?Skilled nursing care?Short-term rehabilitation?Memory care?LOCATION Is the community conveniently located for friends and family to visit?Is the community near preferred medical providers?OVERALL IMPRESSIONDoes the community look and feel like a place you could call home?Sources: www.whereyoulivematters.org, a resource powered by the American Seniors Housing Association (ASHA) and www.medicare.gov, Medicare's Nursing Home Checklist
Choosing a Personal Care Home is one of the most important decisions a family can make. While many people immediately look at large facilities, there's something special about smaller, more intimate care environments that can make all the difference in a senior's quality of life.The Heart of Personalized CareSmaller Personal Care Homes offer something that larger facilities simply can't match: genuine, individualized attention. Imagine a place where your loved one isn't just another resident, but a valued individual with unique needs and preferences.What Makes Smaller Personal Care Homes Special?Individual AttentionStaff members know each resident by nameCare plans are truly customizedMore time spent understanding personal needs and preferencesComfortable EnvironmentFeels more like a home than an institutionFamiliar, warm atmosphereReduced feelings of being overwhelmedBuilding Real ConnectionsIn smaller Personal Care Homes, relationships matter. Residents aren't lost in a sea of faces but become part of a close-knit community. They form genuine friendships with both staff and fellow residents, creating a supportive network that feels like family.Social Benefits Include:More meaningful interactionsEasier to participate in group activitiesLess isolation and lonelinessStronger sense of belongingSafety and MonitoringSmaller facilities provide enhanced safety through:Closer staff supervisionQuicker emergency response timesMore attentive health monitoringPersonalized safety protocolsFinancial ConsiderationsContrary to popular belief, smaller Personal Care Homes can be more budget-friendly. With lower overhead costs, they often provide:More flexible pricingTransparent fee structuresPotential for customized payment plansBetter value for personalized careEmotional Well-Being MattersThe emotional impact of a smaller Personal Care Home cannot be overstated. Seniors who feel seen, heard, and valued experience:Increased happinessBetter mental healthHigher quality of lifeReduced anxiety about living away from homeChoosing the Right HomeWhen evaluating Personal Care Homes, consider:Staff-to-resident ratioQuality of interactionsFacility layout and designActivity programsResident testimonialsFamily involvement opportunitiesRed Flags to Watch For:Impersonal treatmentLimited activity optionsRigid schedulesLack of individual attentionThe Human TouchUltimately, the best Personal Care Home feels like an extension of family. It's a place where:Residents are respectedIndividual personalities are celebratedDignity is preservedCompassion guides every interactionSelecting a Personal Care Home is deeply personal. While larger facilities might seem impressive, the magic often happens in smaller, more intimate settings. The goal is finding a place that doesn't just provide care, but truly feels like home.Take your time, visit multiple facilities, ask questions, and trust your instincts. The right Personal Care Home will feel welcoming, warm, and full of genuine human connection. Remember: It's not about finding a place to live, but discovering a community where your loved one can thrive. Contact us today at REWARD Senior Care to learn more and to visit with us for a tour! We are small, family-owned and run community based out of Turtle Creek.
When searching for a Personal Care Home, many families overlook a crucial factor: the difference between a national chain organization and a local, family-owned and -operated community. This distinction can significantly impact the quality of life for residents and their loved ones.Family-run businesses in the senior living industry often prioritize the well-being of residents above all else. A family-owned Personal Care Home typically focuses on making a meaningful difference in people's lives, creating an environment that feels more like home.Lets explore five key benefits of choosing a family-owned Personal Care Home:1. Resident-Centered CareFamily-owned Personal Care Homes often prioritize the needs of residents. The primary goal is to ensure that each individual receives the care and attention they deserve. In these settings, residents are treated with compassion and respect, akin to how one would care for their own family members. This resident-centered approach leads to higher satisfaction and improved quality of life.2. Hands-On LeadershipOne of the standout features of family-owned Personal Care Homes is the active involvement of owners in daily operations. This hands-on approach fosters a culture of accessibility and responsiveness. Owners who are engaged with both staff and residents create an atmosphere that resembles an extended family. They often know employees by name and work alongside them, which inspires teamwork and dedication throughout the facility.3. Personalized AttentionIn family-owned Personal Care Homes, residents and staff are not just numbers; they are individuals with unique identities and needs. This personalized approach is often lost in larger corporate settings, where layers of bureaucracy can hinder effective communication and care. In a family-run community, staff members are empowered to make decisions that best serve the residents, leading to more responsive and tailored care.4. Positive Work EnvironmentFamily-owned Personal Care Homes place a strong emphasis on staff well-being, recognizing the direct correlation between employee satisfaction and resident happiness. When staff members feel valued and respected, they are more likely to provide compassionate and attentive service. This supportive work environment fosters camaraderie among employees, which ultimately benefits the residents they serve.5. Affordable PricingUnlike large corporate chains, family-owned Personal Care Homes often have more flexibility in their pricing structures. This can result in more affordable options for families without compromising on care quality. Family-run communities typically prioritize caring for their residents and staff over profit margins, allowing them to offer competitive pricing while maintaining high standards of care.Family-owned Personal Care Homes offer a unique blend of personalized care, engaged leadership, and a warm, family-like atmosphere. These qualities can significantly enhance the living experience for seniors, providing them with a true home rather than just a care facility. When exploring options for Personal Care Homes, considering family-owned establishments could lead to finding a more nurturing and supportive environment for your loved ones. By prioritizing resident-centered care, fostering positive relationships among staff and residents, and maintaining affordability, family-owned Personal Care Homes stand out as excellent choices for those seeking quality care in a compassionate setting. Learn what makes Reward Senior Care unique by giving us a call today.
Our Firm Prepares You for Life What makes our firm different is that we were built with the needs of growing families in mind. We understand you are BUSY, you are growing, you are planning for a life of prosperity and you value ease, convenience and efficiency. You are raising children, and caring for elderly parents, while also working hard to build your own nest egg for a lifetime of support. You want to know youve made the best decisions for your family and that your plan will work when your loved ones need it most. You want to make sure your minor children would be raised by the people you choose, and never by anyone you wouldnt want, and that your teens and adult children are properly prepared to care for you and what you leave behind. You want to feel confident that youve made the right choices, and handled everything so that you arent leaving behind a mess, when something happens. That is our focus as well. Weve developed unique systems to give you the same access to a Personal Family Lawyer as was previously only available to the super-wealthy, so you can have the guidance you need to build and maintain a life of prosperity and wealth. And, to keep your family out of court and out of conflict, which is the greatest risk to the people you love and all you have created, even if youve already worked with a traditional lawyer or created documents online. Our Team Is Here for You We encourage communication with our clients. In fact, weve thrown out the time clocks so you never have to be afraid to call with a quick question. Everything we do is billed on a flat-fee basis, agreed to in advance, so there are never any surprises. We have a whole team to serve you. When you call our office to ask your quick question, you wont have to wait hours or days for a phone call back. Youll get your question answered, right away. And, if you need to schedule a more in-depth legal or strategic call with your Personal Family Lawyer, a call will be scheduled when you're both available and ready for the call so we can make the very best use of your time and not waste your time by leaving voicemail after voicemail back and forth. And, we ensure the most important details of your planning are followed through on and your plan continues to work throughout your lifetime. We have a funding coordinator to ensure your assets are owned the right way throughout your lifetime and none of your assets will end up going through a long, expensive court process or being lost to the state because they were missed after your death. Weve created unique membership programs to keep your plan up to date year in and year out as well as give you access to our Trusted Team of Legal Experts for guidance on ANY legal or financial matter. One day you will need a lawyer. I dont know why and I dont know when, but when you do, you will be grateful you can call on us and well be here to advise you or get you out of a jam. We Help You Transfer Your Life and Legacy Lastly, we believe your financial wealth is only a small part of your overall Life and Legacy Planning which is made up of your far more valuable and most often lost upon incapacity or death intellectual, spiritual and human assets. These assets are what make you who you are, and sum up whats most important to you. And, a survey of inheritors has revealed that what they care about even more than inheriting your money, is inheriting these intangible assets. Most estate plans only focus on the transfer of your financial wealth to the next generation. Most people have such great intentions of passing on the intangible, but very few ever get around to it. Its just not a priority, until its too late. How much do you know about your grandparents values? Their most prized personal possessions? How they felt about you? What they had learned during their lifetime? If you are like most people, you know very little. Thats why we build the capture and passage of these most valuable assets into every estate plan we create. Not only will we help you pass on your money, but also your values, your insights, your stories and your experience the truly valuable assets your loved ones care about the most. Weve developed a tool that allows us to capture and pass on your whole family wealth, including your Intellectual, Spiritual and Human assets. I cant go into all of the details here, but well definitely talk about it when you come in for your Life and Legacy Planning Session.